Living Kidney Donor OPTN

Disease Transmission in Organ Transplantation

With the news that UPMC has temporarily halted their living kidney donor program due to hepatitis transmission to a recipient, I thought I’d pull some OPTN data for my fair readers’ perusal.

These slides are from OPTN’s 2011 spring presentation. (click to enlarge, just be prepared to hit your back button)

The Disease Transmission Advisory Committee classifies these cases into four categories:

Proven: disease in donor and at least one recipient (think deceased donor)
Probable: disease in one or more recipients with suggestive data about donor.
Possible: evidence to suggest but not proven transmission
Intervention Without Documented Transmission: no transmission occurred most likely because antimicrobals were used.
Unlikely: limited evidence to suggest transmission could have occurred but no transmission documented.

2006-2010 (only through October 2010) Proven and Probably transmissions:

5 events involving blood borne pathogens (HIV, HBV, HCV)
7 events involving other viruses
24 events involving bacteria
11 events involving fungi
7 events involving ‘other’ transmissions
30 events involving malignancy (cancer)

This committee has issued ‘guidance’ documents to transplant centers to reduce/eliminate disease transmission and collaborated with OPTN’s Living Donor Committee to improve screening of prospective living donors. While this is obviously a good and necessary thing, the motivation is not quite so crystalline. After all, it’s not as if this increased testing arose out of a need/want to protect and care for living donors. No, the sole concern, as always, is for the recipient.

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